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飞秒激光辅助白内障手术治疗 Fuchs 内皮角膜营养不良:长期疗效观察。

Femtosecond laser-assisted cataract surgery in Fuchs endothelial corneal dystrophy: Long-term outcomes.

机构信息

From the Department of Ophthalmology (Fan, Yan), Tianjin Medical University General Hospital, Tianjin, and the Department of Cataract (Fan, Zhang), Xiamen Ophthalmic Center, Affiliate Xiamen University, Xiamen, China.

From the Department of Ophthalmology (Fan, Yan), Tianjin Medical University General Hospital, Tianjin, and the Department of Cataract (Fan, Zhang), Xiamen Ophthalmic Center, Affiliate Xiamen University, Xiamen, China.

出版信息

J Cataract Refract Surg. 2018 Jul;44(7):864-870. doi: 10.1016/j.jcrs.2018.05.007. Epub 2018 Jun 27.

Abstract

PURPOSE

To compare the corneal endothelial cell loss and central corneal thickness (CCT) after conventional phacoemulsification surgery or femtosecond laser-assisted cataract surgery in patients with Fuchs endothelial corneal dystrophy and senile cataract.

SETTING

Xiamen Ophthalmic Center, Affiliate Xiamen University, Xiamen, China.

DESIGN

Prospective case series.

METHODS

Eyes with mild or moderate Fuchs endothelial corneal dystrophy and cataracts had femtosecond laser-assisted cataract surgery or phacoemulsification. The endothelial cell density (ECD), rate of ECD loss, cumulative dissipated energy (CDE), and CCT were measured preoperatively and 3 days and 1, 3, 6, and 12 months postoperatively.

RESULTS

The study evaluated 31 eyes. The CDE was lower in the femtosecond group than in the phacoemulsification group (P < .05). The preoperative and postoperative ECDs were similar in the 2 groups (P > .05). The rate of ECD loss was higher in the phacoemulsification group from 1 to 12 months postoperatively (P > .05). The CCT was thicker in the phacoemulsification group 1, 3, and 6 months postoperatively (all P > .05). In both groups, the postoperative CCT at all follow-up visits were greater than the preoperative CCT (all P < .01). No bullous keratopathy or other intraoperative complications occurred in either group during the follow-up.

CONCLUSIONS

For eyes with Fuchs endothelial corneal dystrophy and cataract, the CCT 12 months after surgery remained thicker than the preoperative thickness. The femtosecond group, with a lower CDE, tended to have a thinner CCT and less endothelial cell loss than the phacoemulsification group.

摘要

目的

比较常规超声乳化白内障吸除术或飞秒激光辅助白内障手术治疗 Fuchs 内皮角膜营养不良合并老年性白内障患者的角膜内皮细胞丢失和中央角膜厚度(CCT)。

设置

中国厦门眼科中心,厦门大学附属医院。

设计

前瞻性病例系列。

方法

轻度或中度 Fuchs 内皮角膜营养不良合并白内障的眼行飞秒激光辅助白内障手术或超声乳化白内障吸除术。术前及术后 3 天、1 个月、3 个月、6 个月和 12 个月测量内皮细胞密度(ECD)、ECD 丢失率、累积消散能量(CDE)和 CCT。

结果

该研究共评估了 31 只眼。飞秒组的 CDE 低于超声乳化组(P<.05)。两组术前和术后 ECD 相似(P>.05)。术后 1 至 12 个月,超声乳化组的 ECD 丢失率较高(P>.05)。术后 1、3 和 6 个月,超声乳化组的 CCT 较厚(均 P>.05)。两组术后各随访点 CCT 均大于术前(均 P<.01)。在随访期间,两组均未发生大泡性角膜病变或其他术中并发症。

结论

对于 Fuchs 内皮角膜营养不良合并白内障的患者,术后 12 个月的 CCT 仍比术前厚。CDE 较低的飞秒组与超声乳化组相比,术后 CCT 较薄,内皮细胞丢失较少。

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